Provider Demographics
NPI:1902826738
Name:CROWE, MICHAEL J III (DPM)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:J
Last Name:CROWE
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:211 ALDEN ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-4419
Mailing Address - Country:US
Mailing Address - Phone:508-997-4646
Mailing Address - Fax:508-991-5385
Practice Address - Street 1:211 ALDEN ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-4419
Practice Address - Country:US
Practice Address - Phone:508-997-4646
Practice Address - Fax:508-991-5385
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA1719213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0361143Medicaid
4358650OtherAETNA
70263OtherBCBS RI
042882878OtherFEDERAL TAX ID
33052OtherHARVARD PILGRIM
480004429OtherMEDICARE RAILROAD
1417187004OtherCIGNA
721998OtherTUFTS
Y70786OtherBLUE SHIELD
Y70786OtherBLUE SHIELD
042882878OtherFEDERAL TAX ID
T57932Medicare UPIN
4358650OtherAETNA